Basic Information
| Provider Information | |||||||||
| NPI: | 1528388402 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JANOSIK | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 E 2ND ST | ||||||||
| Address2: | SUITE 112 & 114 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852515600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804255000 | ||||||||
| FaxNumber: | 4804255010 | ||||||||
| Practice Location | |||||||||
| Address1: | 9700 N 91ST ST | ||||||||
| Address2: | C-200 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852585054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804255000 | ||||||||
| FaxNumber: | 4804255010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2010 | ||||||||
| LastUpdateDate: | 06/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WW0101X | RN146184 | AZ | N | Nursing Service Providers | Registered Nurse | Women's Health Care, Ambulatory | 164W00000X | RN146184 | AZ | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.